Carriers for drips

The thinking goes that if you're titrating drip rates frequently, a carrier helps with even delivery of drugs. So if you cut a rate by half of one thing, you won't affect another's delivery that much. Conversely, you won't give a big bolus of something when doubling something else.

Just examples.

Also, yes, for line patency. Generally the rule of thumb here for central lines is that if the total fluid going through the line is less than 3ml/hr, it needs a heparinized carrier fluid.

(But with heparin you can just infuse 1ml/hr)

Also, yes, for line patency. Generally the rule of thumb here for central lines is that if the total fluid going through the line is less than 3ml/hr, it needs a heparinized carrier fluid.

(But with heparin you can just infuse 1ml/hr)

Been a whole since I did Peds ICU.... still putting heparin in those lines? Thought they figured out it wasn't necessary?

Carriers are indeed for line patency.

Goes without saying... if there is a line or lumen that is redundant in that crystalloid replacement is being accomplished elsewhere and there are no medications infusing thru it, it can just be capped and flushed.

We try NOT to cap and flush atrial lines, arterial lines and central monitoring lines. It's not a great idea to do it with umbilical lines either.

True, there are some lines that you just dont cap - not worth the risk.

Goes without saying... if there is a line or lumen that is redundant in that crystalloid replacement is being accomplished elsewhere and there are no medications infusing thru it, it can just be capped and flushed.

I am talking about lines that you do have a drip running through. If I have Prostin running at 0.14 ml/hr, that is not going to keep my line patent. We use heparin carriers in our 2 french and 3 french central lines because they do become occluded and they do collect fibrin deposits. Each children's hospital that I have worked at has had a policy similar to this:

Total rate 1-3ml/hr - heparin carrier

3-5 ml/hr - saline carrier may be appropriate

Dextrose in a line running less than 5ml/hr may need heparin.

Been a whole since I did Peds ICU.... still putting heparin in those lines? Thought they figured out it wasn't necessary?

My recent experience is not to use heparin for Pedi patients, but a lot of NICUs still do. Depends on the rate and sometimes the type of line and unit protocols.

Goes without saying... if there is a line or lumen that is redundant in that crystalloid replacement is being accomplished elsewhere and there are no medications infusing thru it, it can just be capped and flushed.

It's not about crystalloid replacement...Its about a carrier in very low rate/volume infusions. Also, getting lines in Pediatric or NICU patients is.very difficult at times so we don't cap as often as in adults.

We use NS carriers for drips less than 1cc/hr. Heparin/ is only used for CVPs and art lines. It's just for patency.

We never cap off. We always use a heparinized flush bag to keep RA lines patent. We do however cap off and heparin lock PICC lines if aren't using the port for any drips. I was always explained that the carrier fluids were to help "carry" the drips into the patient. I never even stopped to think about how the pump already does that! Good for you for using your critical thinking skills. I will be sure to ask at work what the sole purpose of these carrier fluids are next time I go in. Without drips, I know they are for line patency. With drips, I just expected that it was to help push the drips in equally.